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ObjectiveTo systematically evaluate the efficacy and safety of omental wrapping technique for pancreaticojejunal anastomosis in preventing complications after pancreaticoduodenectomy. MethodsThis study was conducted according to the PRISMA guideline. English and Chinese databases including CNKI， Wanfang Data， VIP， CBM， the Cochrane Library， PubMed， Embase， and Web of Science were searched for clinical studies on omental wrapping technique for pancreaticojejunal anastomosis in preventing complications after pancreaticoduodenectomy published up to November 2022， and Stata 16 and Review Manager 5.4 were used to perform the meta-analysis. ResultsA total of 15 studies with 1 830 patients were included in this study. The meta-analysis showed that the omental wrapping group had a significantly lower overall incidence rate of postoperative pancreatic fistula （POPF） than the non-omental wrapping group （odds ratio ［OR］=0.30， 95% confidence interval ［CI］： 0.22 — 0.41， P<0.001）， and the subgroup analysis showed that the omental wrapping group had a significantly lower incidence rate of grade B/C POPF than the non-omental wrapping group （OR=0.29， 95%CI： 0.21 — 0.39， P<0.001）. Compared with the non-omental wrapping group， the omental wrapping group had significantly lower incidence rates of postoperative bile leakage （OR=0.30， 95%CI： 0.16 — 0.56， P<0.001）， postoperative hemorrhage （OR=0.35， 95%CI： 0.24 — 0.53， P<0.001）， delayed gastric emptying （OR=0.45， 95%CI： 0.31 — 0.64， P<0.001）， abdominal infection （OR=0.55， 95%CI： 0.40 — 0.75， P<0.001）， reoperation （OR=0.31， 95%CI： 0.18 — 0.54， P<0.001）， and death within 30 days after surgery （OR=0.42， 95%CI： 0.22 — 0.80， P=0.009）， a significantly earlier time to diet （mean difference ［MD］=-0.98， 95%CI： -1.84 to -0.11， P=0.03）， and a significantly shorter length of postoperative hospital stay （MD=-2.44， 95%CI： -4.10 to -0.77， P=0.004）. There were no significant differences between the two groups in the time of operation （MD=-13.68， 95%CI： -28.31 to -0.95， P=0.07） and intraoperative blood loss （MD=-17.26， 95%CI： -57.55 to -23.03， P=0.40）. ConclusionOmental wrapping can reduce the incidence rates of postoperative complications such as pancreatic fistula， bile leakage， postoperative hemorrhage， abdominal infection， and delayed gastric emptying， improve the prognosis of patients， and shorten the length of hospital stay， without increasing surgical difficulty or time of operation.
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OBJECTIVE@#To compare the effectiveness of TiRobot-assisted and C-arm X-ray fluoroscopy assisted percutaneous kyphoplasty (PKP) via pedicle of vertebra in the treatment of osteoporotic vertebral compression fracture (OVCF) of thoracic vertebrae.@*METHODS@#The clinical data of 85 patients with OVCF of thoracic vertebrae who were admitted between January 2020 and March 2023 and met the selection criteria was retrospectively analyzed including 40 patients (50 vertebrae) undergoing PKP assisted by TiRobot (group A) and 45 patients (50 vertebrae) undergoing PKP assisted by C-arm X-ray fluoroscopy (group B). There was no significant difference in the comparison of baseline data such as gender, age, body mass index, bone mineral density T-value, fracture segment, trauma history, and preoperative numerical rating scale (NRS) score, Oswestry disability index (ODI), and Cobb angle of injured vertebra between the two groups ( P>0.05). The effectiveness evaluation indexes of the two groups, including the operation time, the volume of injected cement, the times of fluoroscopies, the length of hospital stay, and the occurrence of postoperative complications were collected and compared. Anteroposterior and lateral X-ray films and CT of the injured vertebra were reviewed at 1 day after operation to observe whether there was cement leakage and to evaluate the distribution of cement in the injured vertebra. Before and after operation, pain was assessed using the NRS score, dysfunction was assessed using the ODI, and vertebral height recovery was assessed by measuring the Cobb angle of the injured vertebrae by X-ray films.@*RESULTS@#Both groups of patients successfully completed the operation, the operation time, the volume of injected cement, the times of fluoroscopies, and the length of hospital stay in group A were significantly less than those in group B ( P<0.05). The patients in two groups were followed up 4-12 months (mean, 9.6 months). Bone cement leakage occurred in 5 vertebrae in group A and 15 vertebrae in group B after operation, all of which leaked to the intervertebral space and around the vertebral body, and the patients had no obvious clinical symptoms. The difference of bone cement leakage between the two groups was significant ( P<0.05). No severe complication such as intraspinal leakage, infection, or vascular embolism was found in the two groups. At 1 day after operation, the distribution index of bone cement in group A was mostly grade Ⅴ, which was well dispersed; while in group B, it was mostly grade Ⅱ and grade Ⅴ; the difference of bone cement distribution index between the two groups was significant ( P<0.05). The NRS score, ODI, and Cobb angle of injured vertebra in both groups were significantly improved at 1 day after operation when compared with preoperative ones ( P<0.05). There was no significant difference in the difference of the above indexes between the two groups before and after operation ( P>0.05).@*CONCLUSION@#TiRobot-assisted unilateral PKP in the treatment of OVCF of thoracic vertebrae is safe and effective, which can reduce the X-ray transmission times during operation, shorten the operation time, reduce the volume of bone cement injection, and thus decrease incidence of bone cement leakage.
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Humans , Thoracic Vertebrae/surgery , Fractures, Compression/surgery , Spinal Fractures/surgery , Kyphoplasty , Bone Cements , Retrospective StudiesABSTRACT
Objective To study the mechanism of Shexiang Baoxin pill in the treatment of atherosclerosis, and to provide a theoretical basis for long-term clinical application. Methods The chemical components and targets of Shexiang Baoxin pill were collected and screened by TCMSP, TCMID, ETCM and BATMAN databases. The targets related to atherosclerosis were collected and screened by DisGeNet, OMIM, TCMSP, DrugBank and DisGeNet. Drug-compound target network and protein-protein interaction network were constructed. Go and KEGG enrichment analysis of Shexiang Baoxin pill in the treatment of atherosclerosis were carried out on MetaScape platform. Results 114 potential therapeutic components of Shexiang Baoxin pill on atherosclerosis were selected, corresponding to 175 targets. The results of network analysis showed that the main active components of Shexiang Baoxin pill were chenodeoxycholic acid, ursodeoxycholic acid, cinnamaldehyde and ginsenoside Rb1. The results of pathway enrichment showed that the anti-atherosclerotic mechanism of Shexiang Baoxin pill was related to the regulation of immunity, inflammation, and metabolism. Conclusion The active components of Shexiang Baoxin pill could act on ALB, INS, AKT1, ACTB, TNF, IL-6 and other targets, regulating multiple pathways to achieve the therapeutic effect on atherosclerosis.
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Objective@#To evaluate the measured value of gadoxetic disodium - enhanced T1-weighted magnetic resonance for the prediction of liver damage (LD) including liver fibrosis and inflammation.@*Methods@#Retrospectively analyzed laboratory data of 115 patients with pathological results including prothrombin time (PT), albumin, serum total bilirubin level (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and magnetic resonance measurements (T1 measurement before and after enhancement and hepatobiliary specific phase T1pre, T1post, and changes in T1 relaxation time before and after enhancement were measured). The correlation between LD and magnetic resonance measurements was assessed by Spearman’s correlation. All cases were divided into two groups: LD < 1 and LD≥1 (n1 = 26, n2 = 89), and the mean value of both groups was compared by t-test or Mann-Whitney U test. The independent influence factors of LD were obtained by binary logistic regression model. The area under receiver operating characteristics (AUROC) curve was performed on T1pre, T1post, and variation values.@*Results@#Spearman's correlation test showed that T1post and variation values were significantly associated with LD, and the correlation coefficients were 0.435, -0.353 and P < 0.05, respectively. The mean values of T1post, variation values, PT, albumin, ALT and AST were statistically significant (P < 0.05). Binary logistic regression model showed T1post (P = 0.006), PT (P = 0.003), and AST (P = 0.032) were independent influencing factors of LD. T1- post contrast was good predictor of liver damage (AUC = 0.800).@*Conclusion@#T1-post contrast predicts the existence of liver damage and provides useful information for clinical diagnosis and treatment.
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An ultra high performance liquid chromatography-photodiode array detection-tandem quadrupole mass spectrometry ( UPLC-PAD-MS/MS) method was developed for the determination of total 13 flavonols and flavonol glycosides in red onion which including 6 quercetin and its glycosides, 4 isorhamnetin and its glycosides, 3 Kaempferol and its glycosides. The chromatographic separation was carried out by used a UPLC HSS T3 column and eluted under gradient with mobile phases of acetonitrile and water both contained 0 . 1%formic acid at a flow rate of 0. 3 mL/min. The results showed that the major flavonols and flavonol glycosides in red onion were quercetin-4’-glucoside, quercetin-3, 4’-diglucoside, quercetin and Isorhamnetin-4’-glucoside. The amounts and distributions of flavonols and flavonol glycosides among different parts of red onion were different. For the same amount of dry materials, the content ratio of total flavonols and flavonol glycosides in the outer two layers, the third layer and the inner layer was 60. 3:33. 0:6. 7, the amount of quercitin and its glycosides accounts above 92. 1% of total flavonols and flavonol glycosides for each part. In the outer two layers, the amount of flavonol monoglycosides are the highest, in the third layer, the amount of flavonol aglycones were the highest, but in the inner layer, the amount of flavonol diglycosides were the highest. Small amounts of Kaempferol and its glycosides were found in red onion, and mostly were found in outer layers. This method is simple, fast, accurate and convenient, and can be used to analyze flavonols and flavonol glycosides in onion product.
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Objective To observe the clinical effect of eye drops of 0.1%olopatadine hydrochloride(patanol) and 0.05%FKS06 (tacrolimus) for treating severe vernal keratoconjunctivitis in children.Design Prospective case siries.Participants 62 cases(104 eyes) of severe vernal keratoconjunctivitis aged 3-14 years old.Methods We observed the symptoms and signs of severe vernal keratoconjunctivitis before and after the treatment of 0.1%olopatadine hydrochloride and 0.05%FKS06.We examined regularly the blood,liver and kidney functions for all patients during treatment.Main Outcome Measures Symptoms and signs.Results Following by 3- 34months,all patients were much better in different degree at 1 week than that before.The papillae were decreased and almost disappeared gradually at 1 month.The corneal lesions were cured rapidly in less than 2 weeks.2 cases(3.2%) complained a little disconfort just at the beginning.38 cases(61.3%) recurred from 2 weeks to 8 months after stopping the eye drops,and were controlled rapidly after reusing the eye drops.The blood routine and the biochemical functions of all patients were normal during treatment.Conclusions 0.1% olopatadine hydrochloride and 0.05%FKS06 have remarkable effects for alleviating symptoms and signs of severe vernal keratoconjunctivitis. The patients are comfortable and content with the treatment,and side effects are very few.